"Anthem Gags without Doctors’ Orders,” says Advocates for Cincinnati Physicians

Anthem’s Cincinnati office unilaterally amended every Tri-State physicians’ contract with a controversial non-disclosure agreement. According to physician advocate, Dan Hounchell, “Anthem’s gag order would restrain physicians from negotiating fair contracts.” In 2004, Hounchell founded Praesentia, LLC to assist Greater Cincinnati physicians in their negotiations with health insurance companies.

Cincinnati, OH (PRWEB) February 19, 2006 -- Anthem’s Cincinnati office unilaterally amended every Tri-State physicians’ contract with a controversial non-disclosure agreement. According to physician advocate, Dan Hounchell, “Anthem’s gag order would restrain physicians from negotiating fair contracts.” In 2004, Hounchell founded Praesentia, LLC to assist Greater Cincinnati physicians in their negotiations with health insurance companies.

Although the government already keeps physicians from openly sharing financial data, Anthem’s gag order apparently quashes anything a physician might try to share with employers and patients. The amendment, however, leaves it up to Anthem’s discretion if it might publicly share similarly confidential information.

How can Anthem change contracts without physicians’ permission? How can they freely disclose information to employers and patients, but restrict doctors from doing the same? Unfortunately, many provider contracts go unexamined for years, leaving doctors and patients vulnerable to companies whose first obligation legally is to shareholders.

Another component to Anthem’s bold move is that most doctors won’t read about it in the first place. A link to the notice was emailed to a fraction of affected physicians, with the actual text of the amendment buried 15 pages deep in an errantly-dated newsletter. Anthem’s notice – dated January 2005 not 2006 – is otherwise only accessible at anthem's website.

Anthem’s amendment newly asserts that “The following section will replace the introduction of the Provider Manual: Provider and Anthem understand and agree that any information regarding the other’s business activities which is not otherwise available to the general public is privileged and confidential."

“To us, it seems Anthem wants to bar doctors from informing employers, patients, and press of unethical behavior and obstructionist tactics insurers routinely employ – like this one, “ says Hounchell.

In response to Anthem’s actions, some doctors are requesting that only material restricted by federal regulations be covered. Praesentia, LLC encourages Tri-State physicians to seek legal counsel to confirm whether or not they are bound by Anthem’s amendment.
    
About Praesentia, LLC:
Cincinnati-based Praesentia, LLC is a privately-owned company, using the Federal Trade Commission’s approved ‘Messenger Model’ for negotiations between physicians and insurance companies. Pointing to healthcare financing and demographic trends in the Ohio, Indiana, and Kentucky markets, Praesentia suggests increased provider reimbursement can actually lower healthcare costs through greater access to care. While much of their work occurs behind the scenes, Praesentia’s efforts routinely appear in the Cincinnati Business Courier and Indianapolis Business Journal.

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